Search Results (7,520)

Background: Osteoporosis is a major complication in older adults with type 2 diabetes mellitus (T2DM). Malnutrition contributes to bone loss, and the Geriatric Nutritional Risk Index (GNRI) has emerged as a simple tool for assessing nutritional status. Evidence on the predictive value of the GNRI for osteoporosis in elderly patients with T2DM remains limited. Objective: To evaluate the association between GNRI scores and osteoporosis and determine its predictive performance in elderly patients with T2DM. Methods: A cross-sectional study was conducted on 200 elderly patients with T2DM attending the internal medicine outpatient clinics at Zagazig university hospitals between January and October 2025. Clinical data, biochemical parameters, and bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip were assessed. GNRI scores were calculated using standard formulas. Participants were classified into osteoporosis and non-osteoporosis groups according to WHO criteria. Correlations and ROC curve analysis were performed to assess the predictive ability of the GNRI in comparison with age, BMI, and serum albumin. Results: Osteoporosis was present in 15% of the cohort. Patients with osteoporosis had significantly lower GNRI scores and lower BMD values at all measured sites (p < 0.05). The GNRI showed significant positive correlations with BMD parameters in both sexes. ROC analysis demonstrated that the GNRI had the highest predictive performance for osteoporosis (AUC = 0.80 for all patients; AUC = 0.85 in males; AUC = 0.77 in females). Optimal GNRI cutoff values were <100.03 for the total sample, <99.10 for males, and <100.3 for females. Conclusions: The GNRI is a valuable and simple clinical tool for predicting osteoporosis in elderly patients with T2DM. Lower GNRI scores are significantly associated with reduced BMD. Incorporating the GNRI into routine assessment may help identify high-risk patients who require early screening and intervention. Full article

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a tick-borne zoonotic pathogen of significant public health concern in South Korea, where human cases continue to occur at high levels; however, information on the molecular epidemiology and genotype diversity of SFTSV in goats—an increasingly important livestock species—remains limited. In this study, blood samples were collected from 750 clinically healthy goats during nationwide surveillance in 2024. Viral RNA was detected by RT-PCR targeting the S and M genomic segments. Epidemiological characteristics were analyzed according to season, region, farm size, breed, and sex. Positive samples were subjected to sequencing and phylogenetic analysis to determine SFTSV genotypes. SFTSV RNA was detected in 10 of 750 goats (1.3%), with significantly higher detection rates in autumn compared with summer, in southern regions compared with northern regions, and in female goats compared with males, while no significant association was observed with farm size or breed. Phylogenetic analysis showed that goat-derived SFTSV strains belonged to genotypes B2, D, and F; notably, genotypes D and F were identified in goats for the first time in South Korea. These findings indicate that goats are exposed to genetically diverse SFTSV strains circulating in tick populations and exhibit epidemiological patterns consistent with tick ecology and human SFTS incidence, supporting the role of goats as incidental or sentinel hosts. Continuous molecular surveillance of goats, integrated with vector monitoring programs, may enhance understanding of regional SFTSV transmission dynamics and facilitate early detection of emerging genotypes with public health implication. Full article

Objective: Homeless individuals are vulnerable, and a high burden of mental health problems is suspected. We aim to identify the prevalence and key predictors of probable depression and anxiety among homeless individuals in Germany during the Coronavirus disease-2019 (COVID-19) pandemic. Study Design: Nationwide multicentre cross-sectional study including clinical, laboratory, and questionnaire-based data on the health of homeless individuals in Germany. Methods: Data were used from the National Survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic. Probable depression and anxiety were determined using the Patient Health Questionnaire 9 and the General Anxiety Disorder 2 questionnaire. Logistic regression analysis was used to identify key predictors of probable depression and anxiety. Results: A high prevalence of probable depression (26.8% [95% CI: 23.2–30.3]) and anxiety (27.2% [95% CI: 23.7–30.7]) was found. Logistic regressions showed both probable depression and anxiety associated with being female (depression: OR 1.80 [95% CI: 1.06–3.03]; anxiety: OR: 1.69 [95% CI: 1.03–2.76]), daily use of any illegal substances (depression: OR 3.20 [95% CI: 1.87–5.49]; anxiety: OR 2.04 [95% CI: 1.21–3.45]), and fear of contracting COVID-19 (little fear, depression: OR: 1.81 [95% CI 1.01–3.23], some fear, anxiety: OR: 2.52 [95% CI: 1.31–4.83]). Probable depression was associated with longer durations of homelessness (OR: 1.004, [95% CI: 1.001–1.007]. Conclusions: Probable depression and anxiety are highly prevalent in homeless individuals throughout. Key predictors may help to identify individuals in need and design targeted interventions. Full article

Spermatogenesis is a sophisticated process coordinated by germ cells and the somatic microenvironment. Circular RNAs (circRNAs), key components of competitive endogenous RNA (ceRNA) networks, form intricate post-transcriptional regulatory systems by sequestering microRNAs (miRNAs). However, the specific functions of these networks in spermatogenesis, particularly regarding the cell-intrinsic regulatory programs of germ cells, remain poorly understood. To address this, we utilized a unique foxl3 mutant model in medaka (Oryzias latipes), in which XX female germ cells spontaneously transdifferentiate into functional sperm within the ovarian somatic environment. This model enables the functional enrichment of core spermatogenic programs largely independent of male-specific somatic cues. Through whole-transcriptome sequencing and bioinformatic analysis, we identified 58 key circRNAs, 27 core miRNAs, and 2965 mRNAs, and constructed a candidate ceRNA regulatory network mediated by six circRNAs. Under genetically consistent conditions, this study elucidated a putative ceRNA network directly involved in the germ cell-dominant initiation of spermatogenesis, suggesting an essential role of these networks in germ cell fate determination. These findings provide new insights into the regulatory mechanisms of teleost spermatogenesis and offer valuable molecular targets for advancing reproductive medicine and improving breeding efficiency in aquaculture. Full article

Background: We aimed to determine paranasal sinus volumes using 3D volumetric measurements and to evaluate the effect of anatomical variations on these volumes, ensuring balanced age and sex distribution during childhood. Methods: Thirteen age groups (0–16 years), each including 10 males and 10 females, were formed. After excluding sinus pathologies, a total of 260 subjects were randomly selected from CT head examinations. Right and left frontal, maxillary, and sphenoid sinus volumes were calculated using 3DSlicer software (version 5.6.2)following manual segmentation of axial CT slices. Also, the presence of right and left Agger Nasi cells, Haller cells, Onodi cells, and concha bullosa were recorded. Results: No significant difference was found between males and females in sinus volumes (p > 0.05). Mean right and left maxillary sinus volumes were 6.23 cm³ and 6.27 cm³ (p = 0.551); frontal sinuses were 0.79 cm³ and 0.86 cm³ (p = 0.170); and sphenoid sinuses were 1.64 cm³ and 1.85 cm³ (p = 0.041). Sphenoid sinus pneumatization appeared in 30% of the 0–6-month group and in over 75% of older groups. Frontal pneumatization began at age 2–3 and exceeded 50% after age 4. Agger Nasi, Haller, Onodi cells, and concha bullosa were detected in 58.8%, 31.2%, 10%, and 22.3% of cases, respectively. Anatomical variations showed no significant effect on sinus volumes (p > 0.05). Conclusions: We developed a paranasal sinus volume chart applicable to routine practice, showing that anatomical variations had no significant impact on the development. This is the first study to investigate the impact of anatomical variations on sinus development and volume, along with the age at which variations emerge, with a balanced distribution of age and sex. Full article

Background: Beyond the direct COVID-19 effects, the pandemic’s broader impact on vulnerable groups, such as patients with systemic sclerosis (SSc), is particularly concerning, especially regarding any resulting increase in overall mortality due to healthcare access disruptions. We aimed to determine excess all-cause mortality in SSc patients before and during the pandemic. Methods: We examined mortality data from Thailand’s Ministry of Public Health database for adults with SSc (ICD-10: M34). According to the WHO methodology, a negative binomial distribution model was used to estimate the expected number of deaths using pre-pandemic data (1 January 2015–31 December 2019). We evaluated actual versus expected deaths during the pandemic (1 January 2020 to 31 December 2022), defining excess mortality as the difference between observed and projected deaths under normal conditions. Results: The total number of all-cause deaths in Thailand was 2,325,384 in the pre-pandemic period and 1,634,121 during the pandemic period. The mortality rate among patients with SSc was 3693 before and 3107 during the pandemic. Of those with SSc, 1785 of the deceased were female, and the observed mortality was significantly lower than expected, with an excess death count of −368 (95% CI: −459 to −277), as well as in males with an excess death count of −123 (95% CI: −198 to −48). However, younger SSc patients (aged 18–29 years) experienced significantly higher excess mortality, with an excess death count of 11 (95% CI: 4–18). Conclusions: During the COVID-19 pandemic, neither sex had significantly higher SSc mortality; however, mortality in younger SSc patients increased significantly compared to pre-pandemic levels, underscoring the need for tailored therapies. Full article

Background/Objectives: We aimed to establish and validate population-based reference intervals (RIs) for serum ferritin (SF) using an indirect, date-driven approach based on real-world laboratory data and to optimize partitioning strategies. Methods: SF results from 29,723 apparently healthy individuals who underwent health examinations at West China Hospital between 2020 and 2024 were retrospectively analyzed. SF was measured on a Roche Cobas e801 electrochemiluminescence immunoassay platform. After Box–Cox transformation, outliers were removed using an iterative Tukey method. Potential partitioning factors were evaluated, and data-driven age cut-points were explored using decision tree regression and verified with the Harris–Boyd criteria. RIs were estimated using nonparametric percentile methods and validated in an independent cohort of 2494 individuals. Results: SF concentrations were significantly higher in males than in females (p < 0.001). In females, SF showed a significant positive association with age (r = 0.466, p < 0.001), whereas no such association was observed in males. Decision tree analysis identified 50 years as the optimal age cut-off for females (R² = 0.2467). The final study-derived RIs were 98.02–997.78 µg/L for males, 10.30–299.55 µg/L for females ≤ 50 years, and 36.61–507.00 µg/L for females > 50 years. In the validation cohort, the study-derived RIs achieved pass rates of 93.83–94.72%, which were significantly higher than the manufacturer-provided RIs (37.12–73.97%, all p < 0.001). Conclusions: Using a large health examination database and a multi-step partitioning strategy, we established robust sex- and age-specific SF RIs on the Roche Cobas e801 platform for the local population. This work provides a reproducible, generalizable framework for indirect RI determination of other biomarkers. Full article

Insects are increasingly recognized as sustainable protein sources due to their high feed conversion efficiency and low environmental impact. Among them, the superworm, Zophobas morio (Fabricius) (Coleoptera: Tenebrionidae), has strong potential for large-scale production; however, optimized feeding strategies under tropical conditions remain limited. This study aimed (1) to determine the optimal feed formulations and feeding rate using wheat bran supplemented with the KMITL Protein Innovation source (a protein feed ingredient developed by the School of Agricultural Technology, King Mongkut’s Institute of Technology Ladkrabang, KMITL), and (2) evaluate the influence of plant-based supplementary foods on larval performance. In Phase I, larvae were reared on 13 formulations with three protein levels (CP00, CP21, and CP24) and five feeding rates (A–E). Diets CP21–21 and CP24–21 (21 and 24% CP; wheat bran/protein = 2:1) resulted in the highest survival (83.4–84.1%) and the lowest feed conversion ratios (FCR = 2.29–2.34). Moderate feeding rates (C–D; 925–1110 g feed per tray for 50 days) produced the greatest larval weights (700–760 mg), whereas ad libitum feeding provided no additional benefit. In Phase II, larvae reared on CP21–21 with a restricted rate of 1100 g per tray and supplemented with ten plant-derived foods achieved comparable final weights (716–760 mg), but survival varied significantly among treatments. Mulberry leaf yielded the highest survival (95.3%), followed by banana, watermelon rind, winter melon, and jicama (>90%). Pumpkin and jicama accelerated pupation and adult emergence, showing a female-biased sex ratio among emerged adults (59.2–65.5%), suggesting enhanced developmental rates. These results establish a practical framework for cost-effective and sustainable Z. morio production under tropical conditions, contributing to circular bioeconomy strategies and supporting insect-protein innovation. Full article

Reproductive performance in livestock and poultry is a core determinant of economic efficiency in the animal industry. While traditional research has primarily focused on genetics, endocrinology, and immune regulation, emerging microbiome studies reveal that commensal microbiota within the gut and reproductive tracts play an underestimated yet pivotal role in host reproductive health. This review systematically synthesizes recent advances regarding the relationship between the microbiome and reproductive functions in major livestock species (cattle, pigs, sheep, and chickens). We first delineate the theoretical basis and mechanisms of the “gut-reproductive axis,” highlighting cross-system communication mediated by microbial metabolites, including short-chain fatty acids (SCFAs), indoles, and bile acids. Subsequently, we provide an in-depth comparative analysis of the microecological features of both female (vagina/uterus) and male (semen/epididymis) reproductive systems, examining their impacts on fertility, sperm quality, and pregnancy outcomes. Furthermore, we explore the molecular and systemic mechanisms governing microbial regulation of reproduction, encompassing the modulation of the hypothalamic-pituitary-gonadal (HPG) axis, the balance of local mucosal immunity and inflammation, and epigenetic regulation. Finally, we address current challenges—such as causal validation and the scarcity of multi-species databases—and propose future directions, including spatial multi-omics, AI-integrated analysis, and microbial intervention strategies. Ultimately, this review aims to offer a theoretical foundation and translational insights for elucidating reproductive regulatory networks and developing microbiome-driven precision strategies to enhance reproductive performance. Full article

Background/Objectives: Energy availability (EA), defined as the dietary energy remaining after exercise energy expenditure (EEE), is a central determinant of both health and performance in athletes. Chronic insufficient EA leads to low energy availability (LEA), which is an underlying mechanism of Relative Energy Deficiency in Sport (REDs). This narrative review critically explores the conceptual evolution of EA and LEA, summarizes current physiological evidence, and discusses methodological and practical challenges in their assessment and application in free-living athletes. Methods: Evidence from experimental and observational studies was reviewed to describe the hormonal, metabolic, and performance outcomes associated with LEA. Screening tools, including the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Low Energy Availability in Males Questionnaire (LEAM-Q), were also evaluated for their validity and applicability in different sports contexts. Results: LEA is associated with alterations in thyroid and reproductive hormones, which, in turn, contribute to reduced resting metabolic rate, lower bone mineral density, and delayed recovery. While screening questionnaires can help identify athletes at risk, their accuracy varies by sport and individual characteristics. Incorporating hormonal and metabolic biomarkers provides a more direct and sensitive method for detecting physiological stress. Measuring dietary intake, EEE, endocrine balance and body composition in real-world settings remains a major methodological challenge. Combining hormonal, metabolic, and behavioral indicators may improve the identification of athletes experiencing LEA. Conclusions: EA plays a central role in the interaction between nutrition, exercise, and athlete health, but methodological limitations in its assessment may compromise accurate diagnosis. Improving measurement techniques and adopting integrated monitoring strategies are essential to improve early detection, guide individualized nutrition, and prevent RED-related health and performance impairments. Full article

There is little evidence of the implementation of the Principles for Responsible Investment in Agriculture and Food Systems between universities and businesses, and there is even less research that prioritizes people and implements sustainable development with a territorial focus. In this article, we address a form of collaborative work that integrates academia with business, where the Principles for Responsible Investment in Agriculture and Food Systems (CFS-RIA) are seen as an opportunity to promote and strengthen the management of a business in the communities where it operates, and determine a new way of working from its links with the university. The experience is developed in the provinces of Santiago Rodríguez, Valverde (Mao), and Dajabón in the Dominican Republic, with the aim of contributing, using this new approach, to economic, social, environmental, and governance development in the territory. The conceptual and methodological basis for the university–business link is Working With People, a model that integrates key elements of planning such as social learning, collaborative participation, and project management models. The main catalysts of the experience are the business values and the stakeholders who insert the principles into their programs and projects. Among these is an innovative Family Social Responsibility Program with female entrepreneurs and organic banana production. It is concluded that the implementation of the CFS-RIA Principles has a significant impact on the sustainable development of the region and that the university–business link reinforces the social responsibility of companies, providing an opportunity for the entry of new actors. Full article

Hypoxia–ischemia (HI)-related brain injury impacts millions of neonates worldwide. Male neonates are two times more susceptible to developing HI. We have previously reported that the administration of the neurotrophin receptor tyrosine kinase B (TrkB) agonist 7,8-dihydroxyflavone (DHF) following neonatal HI increases hippocampal TrkB phosphorylation and improves hippocampal-dependent learning and memory in early adult life only in females. We hypothesize that sex differences in HI outcomes are due to alterations in neonatal hippocampal steroid content, mainly the neural testosterone. At postnatal day 9, C57BL/6J mice underwent sham and Vannucci’s HI surgeries and were treated either with DHF or vehicle control. Hippocampi and plasma were collected on days 1 and 3 post-HI and liquid chromatography tandem mass spectrometry was used to determine the testosterone (T), estradiol (E₂), progesterone (P₄), and corticosterone (CORT) contents in these samples. All hippocampal steroid contents were at least 10-fold higher than in plasma, suggesting neural synthesis. Males had higher hippocampal T content than females at 3 days post-HI. Treatment with DHF reduced T in the female hippocampi at 3 days post-HI, but not in males. These findings suggest that the neuroprotective effect of DHF in females may be mediated, at least in part, through the reduction in hippocampal T following HI. Full article

Background: Inflammatory activity in rheumatoid arthritis can be determined by normal blood count ratios such as Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Systemic Immune Inflammation Index (SII), and C-reactive Protein (CRP). Objective: The aim of this research is to determine how these markers change after therapy and whether their pre- and post-treatment differences follow patterns that allow for simple parametric analyses. Methods: A prospective cohort of 52 RA patients (30 females and 22 males) was examined. The patients’ blood samples were tested at baseline and at the end of their 6-month Infliximab treatment. Hematologic markers such as NLR, PLR, and SII were calculated from the complete blood count (CBC), and CRP levels were measured. The statistical methods of Shapiro–Wilk (SW), Kolmogorov–Smirnov (KS), and Anderson–Darling (AD) were used, and later, paired t-tests were used to generate statistics where necessary. Results: Post-treatment measurements were consistently lower for all four biomarkers. QQ-plots and formal tests revealed that the differences between findings were essentially normal, allowing for paired t-tests. The mean decreases were as follows: NLR −1.10 (95% CI −1.48 to −0.71), PLR −43.0 (−55.4 to −30.7), SII −299 (−388 to −211), and CRP −11.36 (−13.18 to −9.54), all p < 0.001. CRP showed the greatest drop, with significant decreases in PLR and SII and a moderate decline in NLR, indicating therapy-related attenuation of systemic inflammation. Conclusions: The study shows that six months of infliximab therapy results in a consistent post-treatment decrease in all four biomarkers: NLR, PLR, SII, and CRP. Because the pre-post differences were roughly normal, CRP revealed the greatest decrease, with significant decreases in PLR and SII and a moderate decrease in NLR, consistent with systemic inflammation reduction. When combined, the CBC-derived indices track with CRP and can serve as practical, low-cost markers for monitoring therapy response in RA, despite the single-arm design. Full article

Background/Aim: Fatigue is a common symptom in individuals with chronic obstructive pulmonary disease (COPD) and is associated with reduced quality of life. The aim of this study was to evaluate the relationships between dietary omega-3 (n-3) and omega-6 (n-6) fatty acid intake, obesity, and stress with fatigue in patients with COPD. Materials and Methods: This descriptive cross-sectional study was conducted between 1 February and 31 July 2025, in the pulmonary outpatient clinics of Ağrı Training and Research Hospital in Ağrı and Atatürk University Research Hospital in Erzurum, Türkiye. Study data were collected using a General Information Questionnaire, the COPD and Asthma Fatigue Scale (CAFS), the Perceived Stress Scale (PSS), and an Adult Semi-Quantitative Food Frequency Questionnaire. Higher CAFS scores indicate greater fatigue severity, while higher PSS scores reflect higher perceived stress. Results: CAFS scores correlated strongly with perceived stress (r = 0.718, p < 0.001) and moderately with COPD exacerbation frequency (r = 0.426, p < 0.001). Although higher n-3 intake was inversely associated with fatigue in univariate analyses, this association weakened after adjustment, suggesting that fatty acid composition was not an independent determinant of fatigue. The n-6/n-3 ratio showed a weak positive correlation with fatigue (r = 0.184, p = 0.024). Female reported higher fatigue levels than male (mean [SD], 60.2 [19.3] vs. 51.9 [19.8]; p = 0.042), and patients with comorbid conditions had higher fatigue scores than those without comorbidities (58.1 [18.3] vs. 46.8 [19.4]; p = 0.001). Smoking status was not significantly associated with fatigue (p = 0.788). In backward multiple linear regression analysis, perceived stress emerged as the strongest independent predictor of fatigue (β = 0.519, p < 0.001). Comorbidity presence (β = 0.206, p = 0.030) and smoking status (β = 0.178, p = 0.026) were also significant, while exacerbation frequency (p = 0.062) and female (p = 0.053) showed borderline associations. Conclusions: These findings indicate that fatigue in COPD is primarily influenced by psychosocial stress and multimorbidity, highlighting the importance of integrative management approaches that address mental health burden and comorbid conditions alongside respiratory treatment. Full article

As chatbot technology becomes increasingly prevalent across a wide range of industries, it is crucial to explore the factors that shape user satisfaction with this AI-driven innovation. This research provides insights into how age and gender impact user perceptions and engagement with AI-driven health technologies in Saudi Arabia. The information systems success model has been utilised to determine the effect of age and gender on user satisfaction. A self-administered questionnaire was distributed in two hospitals in Makkah City, Saudi Arabia, and 527 responses were collected from chatbot users. Structural equation modelling via analysis of moment structures validated the model constructs. The findings revealed that the privacy issue on user satisfaction has been significantly greater with males than with females. However, the correlation between user satisfaction and continuance usage intention, as well as net benefits, has been much higher among the females. Also, notable differences were found between user satisfaction and net benefits and continuance usage intention and net benefits, especially when comparing younger and older participants. Across all age groups, user satisfaction consistently emerged as a central driver of continuance usage intention and net benefits, underscoring the importance of fostering satisfaction to enhance the effectiveness of AI-driven chatbots in digital health services. This study can serve as a guide to highlight the importance of chatbot user satisfaction and provide implications, limitations, and future research opportunities. Full article